This application is for a Midcareer Investigator Award (K24) to support Patient-Oriented Research and Mentoring in obesity. This award will support 50% of Dr. Wee's effort for each of 5 years. Dr. Wee will devote 30% effort to mentoring postdoctoral fellows, junior faculty, and other research trainees in obesity investigation, and another 20% to expand the scope of her current research program. Dr. Wee will provide her trainees with structured mentoring and research training and assist them in initiating their own investigations and mentor them through the stages of career development. Trainees will be able to leverage the resources of Dr. Wee's current research program which includes 2 active R01 projects. The first project analyzes 3 large nationally- representative datasets to understand the interplay of race and obesity on 4 outcomes: 1) mortality; 2) novel cardiovascular risk factors; 3) delays in the diagnosis and control of traditional cardiovascular risk factors; and 4) healthcare expenditures. The objective of this project is to clarify whether previously observed attenuations in obesity's adverse impact on mortality and health expenditures in Africans Americans (AAs) relative to Whites can be explained by racial differences on several fronts: competing health risks; an attenuated relationship between obesity and novel cardiovascular risk factors in AAs; and disparities in diagnosis and treatment. In new research, Dr. Wee proposes a novel application of competing risk models to estimate the degree to which competing (nonobesity-related) mortality risks explain observed racial differences in BMI-mortality relationships derived from more traditional analytic methods. Dr. Wee's second R01 project is a multicenter cohort study to understand how patients value weight loss and make decisions about weight treatment particularly weight loss surgery (WLS). The goals of this project are to 1) describe the perspectives of patients in terms of their utility (value) and expectations for weight loss and their willingness to take risks to achieve weight loss; 2) identify predictors that are associated with better WLS outcomes, and 3) understand the factors and barriers patients in primary care encounter in deciding whether or not to undergo WLS and other weight treatments. In new research, Dr. Wee proposes to create a blood sample data repository to explore the role genetic and other biomarkers play in patient decision-making and in predicting outcomes of WLS. This K24 award will allow the creation of a mentorship program in obesity patient-oriented research and allow Dr. Wee to expand her research portfolio in new directions that will guide clinical decision-making and public health policy related to obesity.